OP0306-HPR POINTS TO CONSIDER FOR PATIENT EDUCATION PROVIDED BY NURSES ON METHOTREXATE USE. A EUROPEAN CONSENSUS INITIATIVE
Authors: A. Marques, P. Livermore, U. Martin, A. Ludvigsen, K. El Aoufy, C. Matos, Á. Ágoston-Szabó, D. Batšinskaja, K. Buerki, A. Camon, K. Claes, U. Erstling, M. L. Karlsson, M. Konstantinou, E. Moholt, J. Melicharová, M. Nikoloudaki, A. Pais, C. Paiva, A. I. Rodriguez Vargas, S. Makri, E. Nikiphorou, R. J. O. Ferreira
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Methotrexate (MTX) is the anchor and most prescribed disease-modifying anti-rheumatic drug (DMARD) for inflammatory rheumatic diseases (IRDs). This treatment can be very efficacious but can also have serious, life-threatening side effects. Adequate education and follow-up of patients/carers are therefore essential and dedicated rheumatology nurse consultations are an important part of this. However, many patients across European countries do not have access to these nurse consultations and there are no agreed and clearly defined standards of care on this topic[1]. <h3>Objectives</h3> To develop points-to-consider (PtC), based on the best available evidence and experts' opinion, on the nursing education of patients (or carers) with IRDs taking MTX. <h3>Methods</h3> A nominal group of adult and pediatric nurses (n=19) from 16 European countries, one rheumatologist, one pharmacist, and two patients, was established by the Portuguese Association of Health Professionals in Rheumatology (APPSReuma). The group convened virtually to agree on the protocol for developing the PtC, including the research questions for a scoping review and for a European survey to collect patients', nurses' and rheumatologists' experiences and perceptions about MTX education. The results from the scoping review and the surveys (presented elsewhere) were then used to devise and refine overarching principles and specific PtC statements through two virtual meetings and one online Delphi questionnaire. European Standard Operating Procedures for the development of recommendations/PtC were used.[2] <h3>Results</h3> The group reached consensus on three overarching statements and five PtC (Table 1). Almost all PtC were based on available scientific evidence, and all obtained high levels of agreement (&gt;8/10). <h3>Conclusion</h3> A set of PtC to improve the quality of care provided to patients with IRDs and their carers regarding the education and support that should be provided by nurses specifically on MTX use, has been developed. The ultimate goal is to optimize MTX intake, improve efficacy, reduce side effects and ensure adherence to treatment. A plan is currently underway for the uptake and implementation of these PtC, recognizing the crucial role that the multi-professional rheumatology team plays in this. <h3>References</h3> [1]Robinson S. et al. Musculoskeletal Care. 2017;15:281–292. https://doi.org/10.1002/msc.1212 [2]van der Heijde D. et al. Annals of the Rheumatic Diseases 2015;74:8-13. http://dx.doi.org/10.1136/annrheumdis-2014-206350 <h3>Acknowledgements</h3> This study was funded by an unrestricted grant from medac, without any involvement in the scientific work. <h3>Disclosure of Interests</h3> Andrea Marques: None declared, Polly Livermore Consultant of: Nordic Pharma, Grant/research support from: GOSH NIHR BRC and NIHR Personal Fellowship, Una Martin: None declared, Ane Ludvigsen: None declared, Khadija El Aoufy: None declared, Cristiano Matos: None declared, Ágnes Ágoston-Szabó: None declared, Darja Batšinskaja: None declared, Kristina Buerki: None declared, Angela Camon: None declared, Karlien Claes: None declared, Ulrike Erstling: None declared, Marie-Louise Karlsson Speakers bureau: Novartis, Grant/research support from: Novartis, Mikaella Konstantinou: None declared, Ellen Moholt: None declared, Jana Melicharová: None declared, Myrto Nikoloudaki: None declared, Ana Pais: None declared, Claudia Paiva: None declared, Ana Isabel Rodriguez Vargas: None declared, Souzi Makri: None declared, Elena Nikiphorou Speakers bureau: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Lilly, Fresenius, Paid instructor for: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Lilly, Fresenius, Grant/research support from: Lilly, Pfizer, Ricardo J. O. Ferreira Speakers bureau: Sanofi, MSD, Paid instructor for: UCB, Consultant of: medac, abbvie, roche, Sanofi, Amgen, Grant/research support from: Abbvie.